生醫陶瓷玻璃於牙本質過敏症之治療

Treatment of Dentin Hypersensitivity with a Bioactive Glass

牙本質過敏症是臨床上病人常有的主訴。而目前臨床上的治療方法皆未臻理想。市售的生醫玻璃Abmindent I®是一種新的生醫玻璃系統，宣稱對牙本質過敏症具有療效。本研究嘗試以電子顯微鏡觀察Abmindent I®處理過之牙本質表面及剖面，其牙本質小管被封閉的情形；同時對Abmindent I®硬化前後之粉末進行X光繞射分析，藉以了解生醫玻璃對牙本質小管封閉作用的機轉，以利日後研發新一代治療牙本質過敏症之生醫玻璃製劑。本實驗將Abmindent I®依照使用指示塗佈於處理好的牙本質表面上。靜置7天之後，使用掃描式電子顯微鏡觀察其表面及剖面。XRD的結果顯示Abmindent I®的粉末並沒有特定的結晶相，而硬化後之Abmindent I®則有一新生成之結晶相，經比對後為含水的鈣磷化合物[Ca3H2（P2O7）2‧H2O]。電子顯微鏡的觀察結果則顯示，Abmindent I®只能將部分的牙本質小管封閉，進入牙本質小管之深度約2μm。同時，其硬化時間長達5至7天，有硬化時間過長的缺點。因此，Abmindent I®在臨床上治療牙本質過敏症的成效仍有待進一步的臨床實驗加以證實。而如何縮短治療藥劑的作用時間，有效降低環境因素對於治療藥劑的不良影響，並且能讓治療藥劑深入牙本質小管將之封閉，則是日後研發新一代治療牙本質過敏症之生醫玻璃製劑所需要加以努力的方向。

Dentin hypersensitivity is a common complaint of dental patients. Up to this day, there is no effective treatment for this general complaint. Abmindent I® is a commercialized bioactive glass that recently claimed to be effective on dentin hypersensitivity. This study is primarily to observe the microstructure of the dentin surface that is treated by Abmindent I® in an attempt to see the progress of occlusion in the dentinal tubules. In addition, by the use of XRD analysis, we are able to gain further understanding of the occlusion mechanism of Abmindent I®. In this study, we applied Abmindent I® on dentin surface according to manufacturer’s instructions. Seven days later, we observed the microstructure of the glass treated dentin surfaces and split surfaces with scanning electron microscopy (SEM). The results of XRD revealed that though the powder of Abmindent I® was amorphous before setting, there was crystal formation of [Ca3H2(P2O7)2。H2O] after setting. The SEM results also showed that only a few dentinal tubules were occluded by Abmindent I®, and the occluded depth was about 2 μm. The setting process of Abmindent I® was lengthy, taking about 5 to 7 days. Therefore, the clinical effectiveness of Abmindent I® should be further evaluated by clinical studies. Future investigation should focus on shortening the setting time and increasing the sealing depth of treating agents.